I believe that a robust employee recognition program can/will increase employee satisfaction and increase the organization’s customer service rating. In the past, employees were recognized according to their section leadership. Some were recognized and others were not. Since the implementation of the group wide recognition program, I believe the employees are happier. I will verify this through an electronically administered survey, observing the customer service trends, and comparing the rate of recognition now versus recognition prior to program implementation. Reviews of the training expectations (make the experience, do it with style, and go above and beyond) will be conducted to ensure their compliance.
The 375th Medical Group (MDG) “Your Medical Home for Healthcare” initiated a new employee recognition program in 2011. They implemented the program while achieving; in 2011 the 375 MDG received NCQA Recognition as Patient Centered Medical Home. In 2010 & 2011 it was named AMC Best Patient Safety Program of the Year. In 2010 it was named as AMC Best Clinic of the Year, awarded 3 year Accreditation by AAAHC, and rated excellent by Health Services Inspection. So, in order to determine if the program was successful we must first look at the background of the MDG. (Saunders, 2012) The medical group is proud to provide many services and consists of different programs as well. “The 375 MDG supports the 375th Air Mobility Wing and 31 tenant units in the global reach mission by providing, expanding, and deploying medical capability for contingency tasking.
The 375 MDG trains healthcare professionals annually through four specialty training programs and sustains the readiness skills of more than 476 active duty and Air Reserve Component personnel. Additionally, the 375 MDG provides health services for more than 26,000 beneficiaries. The 375 MDG is accredited by the Accreditation Association for Ambulatory Health Care, American Dental Association, and College of American Pathologists and has affiliations with the American Hospital Association, and American Medical Association.” (375th Medical Group, 2012)
This organization was formally a hospital with emergency and inpatient services. Today the 375 MDG is a clinic with outpatient services only. With commanders coming and going every two years, all the quantum changes were taking their toll on the staff that remained behind. This was primarily your civilian staff in the world of the military. (Saunders, 2012)
The commander1 had arrived right after an exhausting inspection, which granted the MDG a 3 year accreditation (no inspections for 3 more years). Everyone could breathe easier knowing that the inspection was done. But, wait the commander1 saw things that could be improved. She formed groups and committees. Changed/rearranged meeting names, dates and times. The new commander1 left no stone over looked except staff happiness when it came to changing the organization. The commander1 should have used Lewin’s 3 step change model. The change process would have made the change go smoother. Lewin’s Planned Change Model 3 step process is as follows: step 1) Unfreezing, prepare for the change. This is the most critical and hardest step. Step 2) Movement, implement the change. This is the easiest step. Step 3) Refreezing, reinforce the change. This step is the second most important and difficult step. This may have kept the staff from being so upset with the many changes from above without any real information about the organizations direction from the commander1 herself.
A leadership survey was conducted; it identified commander1 visibility and lack of organization direction as key areas of focus. In October 2011, commander1 made some changes so that she was more visible and delivered information to the staff herself. Even though commander1 made these changes, complaints came in about staff attitude and rudeness. The patient satisfaction surveys were showing signs of unhappy followers. That is when commander1 did something about the staff’s happiness. She formed a customer service group to help with all the complaints about rude service. The patients were happy with the care they received, they were not happy with the way in which it was being delivered.
The first meeting of the group went very well. Commander1 had given clear goals; develop/implement a customer service program by 1 Jan 2012. There are five members of the group which is the average size. Groups normally go through four stages; forming – people are coming together on the team, storming – struggle for leadership role, norming – clear emergence of leader, and performing – members were focused on the task. Our group seemed as though it did these four roles in a matter of minutes. This could be because there were no less than three executive staff members in the group. The ranking member lead and we moved to performing due to the tight time schedule. The group first decided on a name for themselves. They tossed around several ideas until “375 MDG Star Council” became the official name. Then, they decided on how to replace members of the group as each member left. Commander1 had sent several members of the organization to a formal customer service course, so we decide these staff members would be the replacement pool when needed.
Now, we needed to figure out what the staff finds rewarding. We conducted a survey of the entire 375 MDG staff. We collected survey forms from everywhere. When we tallied the forms, it was discovered that we had received less than a third of the forms back. Plan B had been hatched; catch all of the 375 MDG staff members while they are in attendance at commander’s call. A captured audience! Without even counting the surveys, it was obvious that we had a much better collection rate. In the survey we asked only one question; what type of recognition would you like to receive and how would you like to receive it? The staff of the 375 MDG results were as follows from the highest votes to the least: a day off presented by the Group Commander, a certificate of Appreciation from the Group Commander, a written note of appreciation from their respective Squadron Commander, recognition in the weekly Commander’s blog and to be recognized by the Executive Team in front of peers. These were the top five results of the survey the 375 MDG Star Council had to work with.
The 375 MDG Star Council had to develop a set of standards which could be used as guidelines for the recognition process. They challenged themselves with the following: “To recognize those individuals who demonstrate the values and objectives of the 375 MDG STAR program. To identify methodologies to foster a climate and atmosphere where customer focus and service permeates the organization with the ultimate goal of quality healthcare, service excellence and customer satisfaction. To understand the range of options and actions necessary to affect a cultural change in our approach to customer service.” (MDGI36-2803) “The Quality Services Office will oversee the 375 MDG STAR Customer Service awards program. Each member assigned to the 375 MDG may nominate anyone displaying outstanding customer service by completing the nomination form found on the MDG’s Enterprise Information Management (EIM) homepage. 375 MDG military and civilian employees will be recognized under the 375 MDG STAR program.
For 375 MDG contract employees, the 375 MDG STAR council will forward their nomination to the 375 MDG Contracting Services Office for entry into the Contract Tracking and Reporting (CTAR) system.” (MDGI36-2803) A set of guidelines, training, and marketing of the program needed to be developed. The 375 MDG Star Council started with the MDG acronym. The “M” stands for “Make the experience.” A positive customer hand-off would give the person you are sending the customer to information about what is needed and what has been done. It would also send a message to the customer that they are valued because they would not need to explain their situation to another person. The “D” stands for “Do it with Style.” Greet all customers with a smile as you come in contact with them. Remember the “10 foot rule”; if you come within 10 feet of a customer greet them. Take pride in yourself and your job. If you look professional and act professional then you are a professional. The “G” stands for “Go above and beyond.” When giving directions to a customer escort when possible. Stay aware and attentive to the customer’s situations such as letting them know if their provider is running late. The council then had to turn their attention to training. How do we train the entire staff of the 375 MDG? We decided to start as Kurt Lewin’s would, with his 3-step change process. (Kurt, 2012) This first stage of change involves preparing the organization to accept that change which involves breaking down the existing status quo before you can build up a new way of operating.
The key to this is developing a compelling message showing why the existing way of doing things cannot continue. This is easiest to frame when you can point to declining customer satisfaction surveys: These show that things have to change in a way that everyone can understand. To prepare the organization successfully, you need to start at its core. You need to challenge the beliefs, values, attitudes, and behaviors that currently define it. Using the analogy of a building, you must examine and be prepared to change the existing foundations as they might not support additional levels; unless this is done, the whole building may risk collapse.
The transition from unfreeze to change does not happen overnight: People take time to embrace the new direction and participate proactively in the change. In order to accept the change and contribute to making the change successful, people need to understand how the changes will benefit them. Not everyone will fall in line just because the change is necessary and will benefit the company. This is a common assumption and pitfall that should be avoided. Time and communication are the keys to a successful change campaign. People need time to understand the changes and they also need to feel highly connected to the organization throughout the transition period. When you are managing change, this can require a great deal of time and effort and hands-on management is usually the best approach. When the changes are taking shape and people have embraced the new ways of working, the organization is ready to refreeze. The outward signs of the refreeze are a stable organization chart, consistent job descriptions, and so on.
The refreeze stage also needs to help people and the organization internalize or institutionalize the changes. This means making sure that the changes are used all the time; and that they are incorporated into everyday business. With a new sense of stability, employees feel confident and comfortable with the new ways of working. The rationale for creating a new sense of stability in our every changing world is often questioned. Even though change is a constant in many organizations, this refreezing stage is still important. Without it, employees get caught in a transition trap where they aren’t sure how things should be done, so nothing ever gets done to full capacity. In the absence of a new frozen state, it is very difficult to tackle the next change initiative effectively. How do you go about convincing people that something needs changing if you haven’t allowed the most recent changes to sink in? Change will be perceived as change for change’s sake, and the motivation required to implement new changes simply won’t be there. As part of the Refreezing process, make sure that you celebrate the success of the change this helps people to find closure, thank them for enduring a painful time, and help them believe that future change will be successful. With the unfreeze step of Kurt Lewin’s change process being the most difficult and stressful.
The 375 MDG Star Council lead the way by cutting down the “way things are done” which put everyone off balance. This evoked strong reactions in the staff, and that’s exactly what needed to done. By forcing the organization to re-examine its core, the 375 MDG Star Council effectively created a crisis, which in turn can build a strong motivation to seek out a new equilibrium. Without this motivation, you won’t get the buy-in and the participation necessary to effect any meaningful change. What better way to get buy-in, than to start with the top down process. The 375 MDG Star Council trained the Executive Team, who would then in-turn preached the new concept to their respective squadrons. Each squadron commander would then gather their managers to be trained within the next two-weeks. The squadron commander would lead off the training program with their support and motivation on how important the program is to the organization. The 375 MDG Star Council then conducted the training for the management staff. This took place within all five squadrons and their management teams. No more than a week later each manager had to go back and deliver the training to their sections and report back to the Executive Team when the training was completed and what percentage of staff was captured.
To sustain the training it will be conducted during newcomers orientation and as requested by leadership or if trends dictate the need. While the training was being conducted on all levels the 375 MDG Star Council initiated the marketing campaign which transformed into the development of the wall of fame, an “I got caught” campaign which asks the question, “How do you serve our nation’s heroes and their families?” (MDGI36-2803) The 375 MDG Star Council purchased and distributed chrome plated name plates at each clinical patient check-in desk. The 375 MDG Star Council needed to develop a way to show at a glance that 375 MDG staff member was recognized for displaying outstanding customer service. A plastic blue card with the MDG logo and explanation on one side and the phrase “The 375th Medical Group is proud to serve our Nation’s Heroes and their families.” (MDGI36-2803) On the bottom of the card is “MDG STARS” each time a staff member is recognized one of the letters is punched in the shape of a Star. This will cause our customers to ask about the card and a way for 375 MDG staff to recognize one another. What is considered worthy of a nomination? “An act that goes above and beyond the normal expectations of daily customer service actions.
These actions may be towards either our internal or external customers.” (MDGI36-2803) “The individual making the nomination may send, through electronic means or in writing, the justification as to why they believe the individual warrants this award to any member of the 375 MDG Star Council. Electronic nominations are accomplished by selecting the “STAR Catcher” banner found on the MDG STAR EIM homepage. Customer service comments provided on the 375 Medical Group Customer Satisfaction Survey forms and Service Delivery Assessment (SDA) will be transferred into the MDG STAR Catcher database.” (MDGI36-2803) “All customer service submissions will be compiled monthly and validated by the 375 MDG Star Council. The 375 MDG Star Council will punch individuals’ Star badges based on valid submissions. Additionally, the council will maintain a system to track all Star punches for MDG personnel.
Individuals who receive their initial punch will earn a blue Star badge holder; individuals who receive their third punch will be recognized in the weekly MDG Commander’s blog. Individuals who receive their fifth punch will receive a written note of appreciation for their respective squadron commander. Individuals who receive their seventh punch will receive a certificate from the group commander. Individuals who receive their tenth punch will earn a one day pass for military personnel and one-day time-off incentive award for civilian employees. Individuals who receive more than ten punches will Start back at third punch for recognition. For example, individuals who receive their thirteenth punch will be recognized in the weekly MDG Commander’s blog.” (MDGI36-2803) “Monthly, the 375 MDG Star Council will determine the top three customer service submissions. These top three personnel will be showcased on the Wall of Fame board and on the 375 MDG Star EIM site.
In addition, they will be nominated for the Wing’s Quarterly Customer Service recognition program. Quarterly, the 375 MDG Star Council will submit three individuals for the wing’s quarterly customer service recognition program. These individuals will be selected from the three months prior nominees. Monthly, the 375 MDG Star Council will randomly identify three 375 MDG employees for the “I got caught… Serving our Nation’s Heroes and Their Families” program. Their picture and comments will be posted on the Wall of Fame and at their duty locations.” (MDGI36-2803)
The customer satisfaction rate is extremely important for the success of any organization. The 375 MDG Star Council will use SDA, customer surveys, patient advocate contacts and secret shopper to validate the employee recognition and reward program. The organizations standard satisfaction rate is 90%. The 375 MDG commander1 wants there to be at a minimum a 90% satisfaction rate at all times; on any given day, at any given time. The top trends/issues for patients contacting the Patient Advocate are; PCM change, Information, Assistance, Communication, Kudos/Access. From this information it would appear that the program is working well. In March 2011 there were a total of 3 positive contacts, 22 negative contacts, and 9 neutral contacts for a total of 34 individuals contacting the patient advocate for assistance of some kind. These numbers have decreased from the same timeframe as last year. (Patient Advocate, 2012)
Not only are the patient advocate contacts tracked, there are feedback forms around the clinic that patients can fill out, in the month of March 2012 there were a total of 136 forms filled out with 14 individuals requesting feedback. 122 forms were positive, 12 were negative, and 2 were neutral. A snapshot of the negative feedbacks were wait time at the pharmacy was too long, waiting too long for an appointment, being told the wrong appointment time and being told to reschedule. Snapshots of the positive feedbacks were prompt and professional, great and very responsive to patients needs. (Patient Advocate, 2012) Not only is the patient advocate available along with paper surveys around the clinic, there is also a contracted company that calls patients and ask ten questions about the visit you had this week.
The contracted company has no information in regards to the visit or the patient’s personal information, to ensure Health Insurance Portability and Accountability Act of 1996 (HIPAA) is complied with, but they ask 10 questions on a 1 – 5 scale to get feedback about the facility and its services. Some of those questions are: How many days did you wait for an appointment; were you satisfied with the care received, management of healthcare needs, and the provider you saw. (Patient Advocate, 2012) Customer satisfaction is very important to this organization and they ensure there are many ways available for customers to voice their concerns; whether good or bad. Communicating with your customers is vital to the success of the organization and providing quality care. This is an important aspect to maintain with all of the cutbacks when it comes to the healthcare industry. Quality care is essential to patient satisfaction and to the delivery of healthcare. There has been a major focus on the delivery of healthcare and the satisfaction of patients in the healthcare industry as a whole.
The 375 MDG Star Council is still in the process of implementing the secret shopper program to assist with validation. They have made progress and will have the program in progress before the end of November 2012. The data from this program is unavailable at the time of publishing. If the data were available I would speculate that it would show a positive trend with a dip here or there.
Overall, the SDA data, patient advocate data, and customer satisfaction surveys all show a positive trend toward program success. The 375 MDG now has a new commander who is very visible, and not just focused on how well the numbers say the organization is doing. The new commander wants to see what bad is being said and if it has a trend. He does like that the organization is maintaining well over the 90% standard, but what is the one or two percent who is not satisfied saying? How can you be sure about the staff and their approval or acceptance of the program?
The 375 MDG employees will be surveyed by the year’s end to validate the program. The survey will be based on the Likert Scale. Likert developed the principle of measuring attitudes by asking people to respond to a series of statements about a topic, in terms of the extent to which they agree with them, and so tapping into the cognitive and affective components of attitudes. (McLeod, 2008) It will contain no more than five questions. The questions will be phrased to ascertain if the employee is aware of the program, knows how the program works, and how frequently do they utilize the program.
The information collected will then be analyzed to determine the effectiveness of the program. Once the determination is made is either for or against the program, appropriate adjustment will be made. The adjustments can range from staff education and training to changing the incentive awards presented to each Star recipient. The Employee Recognition and Reward Program started on 1 Jan 2012 as was charged by the former 375 MDG Commander1. The MDG instruction for the program is posted on the EIM site for all to view at their leisure. The star tracking system has successfully tracked over 1000 star submissions since the January 2012 kick-off.
With Commander2 the customer satisfaction rates at 90% or higher the 375 MDG is meeting or exceeding its goal of the program. 2013 began as it did 3 years ago. In 2012 & 2013 we were named AMC’s Best Patient Safety Program of the Year. In 2013 we were awarded 3 year Accreditation by AAAHC, and currently pending the excellent rating by Health Services Inspection in September 2013. (Saunders, 2012) So, I believe the program to be a success, because with all the leadership changes that has taken place in the organization over the last few years. The organization would not rate as high as it does in customer satisfaction if the program was not working. In January 2013 Commander2 met with the 375 MDG Star Council to discuss the Employee Recognition Program and its current status. Commander2 gave his wish which was to have the Mystery Patient Program operational by 1 May 2013.
The Star Council invited the Patient Safety Representative to assist with the development of the questionnaire. The staff was informed that the Mystery Patient Program was being developed and would be operational by 1 May 2013. The organization began its Mystery Patient Program on 1 May 2013 as commander2 wished. With only one month of data collected and reported. It is this author’s belief that the 375 MDG will see similar results over the next few months to prove the program’s success. Continued education and training of the program will help to increase the patient satisfaction rating over time.